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Isabel Hardman

Does No. 10 really have a plan for social care?

Does No. 10 really have a plan for social care?
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Is the government ever going to reform social care? After a lengthy row between No. 10 and the Treasury, the Queen’s speech does include a promise that ‘proposals on social care reform will be brought forward.’ The stand-off wasn't just over how much those proposals will cost, but the design itself. Perhaps this is why the briefing accompanying the speech is so very light on what the government plans to do.

All we know is that the Health and Care Bill ‘will include provisions to improve the oversight of how social care is commissioned and delivered, and facilitate greater integration between health and care services by placing Integrated Care Systems on a statutory footing across the UK, putting more power and autonomy in the hands of local systems.’ This isn’t a surprise: this NHS-related legislation has been on the cards for a while.

But when it comes to the detail of reform for the funding of social care provision, there is still no more detail than ‘the government is committed to improving the adult social care system and will bring forward proposals in 2021.’ Perhaps more ominously, the briefing also says ‘more widely, we will continue to work with local and national partners to ensure our approach to reform is informed by diverse perspectives, including those with lived experience of the care sector.’ This sentence sounds like the sort of thing no one could disagree with, given it is indeed important to listen to people who understand what it's like to be in the care sector.

But it suggests that ministers haven't done much listening to people in the sector up to this point: talk to anyone who works in this area and they will huff impatiently that everyone knows what the issues are, that politicians have spent more than ten years asking about their ‘lived experience’ and the issue is not listening but doing. The thought of more consultations to respond to, more ‘listening exercises’ and green papers sends a chill down the spine of social care campaigners as they now recognise it as a mere delaying tactic.

I asked Michael Gove about the pace of reform when I interviewed him at the weekend on Times Radio. He insisted that ‘we are working to make sure that we have an effective social care plan at the moment and that work is going on.’ But when I asked him if he could guarantee that a detailed policy would at least be heading for the statute books by the end of this year, he demurred, saying only:

‘We want to make sure that we can get cross party support for it. That is critical, that's the point the Prime Minister has always made, the more support we can get for it across parties – and I hope we do – the quicker we can be.’

The words ‘cross-party support’ also strike fear into those who understand the dynamics of social care reform because politicians have also been saying that phrase for more than a decade, with precious little to show for it.

The problem was summed up to me by one aide working in the health department some years ago: ‘Cross-party support is pointless. Labour and us have fundamentally different ideas about the size of the state and the role of private wealth in this, and we are never ultimately going to agree on the way ahead.’ The Tories have a majority now and so don't even need to get Labour on board in some kind of cross-party talking shop.

It is highly unlikely the Labour party would dare vote against a social care plan that was put before the Commons. So there is no excuse for this lengthy delay. It is not good enough that by the end of the year we might have some ‘proposals’, possibly merely a set of ideas for the sector to respond to. Everyone knows the issues. Everyone knows the possible solutions. The truth is that until the Chancellor of the Exchequer accepts that this will cost the government a great deal of money and until political strategists accept that the public are going to get cross about whatever proposals are put forward for their contributions to care, we will always be stuck in this limbo.

Written byIsabel Hardman

Isabel Hardman is assistant editor of The Spectator and author of Why We Get the Wrong Politicians. She also presents Radio 4’s Week in Westminster.

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